Brent Allan

Funding for 90-90-90

As I sit here at the 2016 International AIDS Conference in Durban, I am listening to a very high-level panel discuss the concerns about what appears to be a trend among middle-income and high-income countries: the tightening of purse strings domestically and in relation to foreign aid.

It is very concerning to know that 13 of the 14 top donors to the Global Fund have decreased their funding, including Australia. What’s even more concerning are the number of countries that don’t even contribute to the fund such as high income countries like Saudi Arabia.

Why is this you ask? Because saving the lives of sex workers, gay men and drug users isn’t popular. However, HIV doesn’t acknowledge the world’s geographical boundaries and there continues to be new cases of HIV every year.

The global call to achieve the UNAIDS ‘Fast-Track’ 90-90-90 targets for 2020 which is 90 per cent of PLHIV will know their HIV status, 90 per cent of PLHIV who know their HIV-positive status are on antiretroviral therapy (ART), and 90 per cent of PLHIV on ART achieving viral suppression, is no small task. We may crow about an end to AIDS in Australia but this is not the case around the world. Globally, these numbers sit at about 40-50-60 at the present moment.

Did you know that for every 1600 people that test HIV-positive worldwide that another 35 PLHIV are lost to care? This ostensibly means people do not get on treatment and they have no HIV care even though they are aware of their status.

Why? Because people are scared of the stigma that follows being HIV positive and/or they can’t afford either the care or the treatments.

This needs to change.

I propose three things that need to happen if we are going to meet those 90-90-90 targets:

We need to treat the right people, in the right places, with the right strategies, and ensure they are linked to care.

We need to extend high quality care to maximise retention and viral suppression.

We need to increase access to biomedical prevention interventions and ensure people who test negative are linked to the most appropriate prevention tools.

As David Ripin of the Clinton Health Access Fund said in closing:

HIV will be a slow moving train wreck if we do not maintain and scale up funding. Finding and treating the first million people is an easy effort done at low costs but it’s funding and treating the last 1000 people which will stretch our efforts and costs beyond what we currently fund. It is the latency of the hidden HIV infections which will build up across decades and decimate our work to date if we allow any government to think their borders can stop a virus.

Doherty Institute

Finding solutions to prevent, treat and cure infectious diseases and understanding the complexities of microbes and the immune system requires innovative approaches and concentrated effort. This is why The University of Melbourne – a world leader in education, teaching and research excellence – and The Royal Melbourne Hospital – an internationally renowned institution providing outstanding care, research and learning – have partnered to create the Peter Doherty Institute for Infection and Immunity (Doherty Institute); a centre of excellence where leading scientists and clinicians collaborate to improve human health globally.

Supported by

Supported by the National Institute Of Allergy And Infectious Diseases of the National Institutes of Health under Award Number U19AI096109. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

About NAPWHA

Founded in 1989, The National Association of People with HIV Australia (NAPWHA) is Australia’s peak non-government organisation representing community-based groups of people living with HIV (PLHIV).